|
02U708Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3397
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U70JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1403
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U70KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1404
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U737Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3398
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U738Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3399
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U73KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1405
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U747Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3400
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U748Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3401
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U74KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1406
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U907Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3402
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U908Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3403
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U90JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1407
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U90KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3404
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U937Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3405
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U938Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3406
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U93JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3407
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U93KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3408
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U947Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3409
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U948Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3410
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U94JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3411
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02U94KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3412
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02UA07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3413
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02UA08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3414
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02UA0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1408
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02UA0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1409
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
